Your Healthy Pregnancy

Pregnancy is a special time. Baby showers, shopping trips to outfit the nursery, and hours spent choosing just the right name for your baby take center stage. Of course, pregnancy does arrive with a supporting cast: indigestion, heartburn and constipation, as well as morning sickness and anxiety over food choices and weight gain.

Kimberly Quach, 33, a family law attorney in Portland, Ore., suffered daylong flu-like symptoms during the first three months of her pregnancy, and she worried about adding too much weight to her stocky frame. She focused on not skipping meals, limiting her intake of unhealthy fats, and substituting a cup of soothing green or brown rice tea for her standard mug of coffee. She also switched from running five times a week to swimming, lifting weights or playing tennis. The result: a healthy baby boy and an improved tennis game.

Eating properly and maintaining your fitness during pregnancy are two of the most beneficial things you can do for your baby — and for yourself. Taking prenatal vitamin-mineral supplements, avoiding alcohol, gaining a healthy amount of weight, and not stressing over every extra brownie you eat are all part of achieving a successful pregnancy, too.

Gearing Up for Pregnancy

The best gift you can give your baby is to clean up your diet and establish a fitness routine before you get the good news that he or she is on the way. Start by taking prenatal vitamin-mineral supplements at least three months before you plan to conceive. (Get your physician's approval before taking herbal or other vitamin supplements.) Prenatal supplements contain folic acid (the manufactured form of the B vitamin folate), which helps prevent up to 70 percent of neural tube defects, such as spina bifida. To reduce these birth defects, you must have adequate folic acid in your system right before and during the first month of your pregnancy, so get at least 400 mcg daily. Synthetic folic acid is well-absorbed, but you also need to get in the habit of consuming foods rich in folate, such as orange juice, lentils, beans, broccoli, spinach and fortified breakfast cereals, since your need jumps to 600 mcg during pregnancy. (Because 50 percent of all pregnancies are unplanned, the March of Dimes recommends that all women of childbearing age get 400 mcg of folic acid daily.)

Establishing a fitness program now means you can continue with your favorite activities (within reason, of course) once you're pregnant. Pregnant women who exercise regularly suffer less nausea and fatigue; are better able to control weight gain; and develop healthy placentas which improves their babies' growth, says James Clapp, M.D., author of Exercising Through Your Pregnancy (Human Kinetics). Check with your physician about specific guidelines for exercising while pregnant. Other healthy habits to establish before you become pregnant: Avoid artificial sweeteners, and limit your intake of caffeinated beverages to one cup a day. Consider alcohol off limits while you're trying to conceive, as well as during pregnancy.

Most mothers-to-be realize the importance of eating healthful foods during pregnancy. But it can be difficult. Your body may be craving ice cream by the gallon, but in reality, "eating for two" means you need only an additional 300 calories a day to gain the 25 to 35 pounds throughout pregnancy that the American College of Obstetricians and Gynecologists (ACOG) recommends for a normal-weight woman.

As Susan Bergoudian, a Boston nutritionist who counsels pregnant women points out, "That isn't much — drinking three cups of non- or low-fat milk will do the trick." Slim women may need to gain as much as 40 pounds, while heavier women should aim for 15 to 25 pounds. But, no matter how you feel about your weight, don't try to lose weight during pregnancy. Underweight women risk giving birth to a low-birth-weight infant with a much greater chance of developing medical, learning and behavior problems.

To get the nutrients you and your baby need, but not unnecessary calories, make the most of what you eat. Carbohydrate-rich foods provide the energy, fiber and B vitamins you need, as well as small amounts of minerals such as iron and zinc. Aim for at least nine servings per day of whole grain foods such as whole-wheat bread, brown rice, and bran cereal or oatmeal; four servings of vegetables; and three servings of fruit. Fruits and vegetables boost your intake of vitamins A and C and folic acid. Fill up on deeply colored varieties such as oranges, berries, apricots, cantaloupe, sweet potatoes, carrots, broccoli and leafy dark greens. As for fat, the unsaturated types from plant sources (vegetable oils, avocado, nuts and seeds) are the healthiest to consume.

Protein Power

Adequate protein is also a must for pregnant women. "Including protein-rich foods at meals and snacks, especially at breakfast and before bedtime, will stabilize your blood sugar so you feel better during the day and sleep better at night," advises Bergoudian. Your body relies on protein to build and maintain muscles; manufacture new cells, enzymes and hormones; fight illness and infections; and produce the extra blood cells your fetus needs to develop normally. Choose from lean meats, poultry or fish, eggs, beans and lentils, soyfoods, nuts and nut butters, and low-fat dairy products. Eat fish two or three times weekly to get omega-3 fatty acids that are favorable for your baby's vision and brain growth.

Your iron needs to double during pregnancy (up to 30 mg a day) for two reasons. First, your body makes more hemoglobin (the oxygen-carrying part of red blood cells), which requires iron; and second, babies draw on their mothers' iron stores to create reserves of their own to last the first three to six months of life, until they start eating iron-rich solid foods. The iron in red meat, poultry and fish is better absorbed than that from prenatal supplements and plant foods such as tofu, beans, lentils, dark green leafy vegetables and dried fruit, but every little bit helps.

You also need a minimum of 1,000 mg a day of calcium during pregnancy to help build your baby's bones and teeth, as well as protect your own bones from osteoporosis. Low-fat or nonfat milk, yogurt and cheese provide about 300 mg a serving, or you can load up on calcium-rich alternatives such as calcium-fortified soy milk, rice milk or orange juice, tofu (prepared with calcium chloride), leafy dark greens and canned sardines with bones. To determine the amount of calcium in foods, check the nutrition labels and add a zero to the percent daily value for calcium. For example, a food supplying 20 percent of the daily value provides 200 mg of calcium.

Feeling Well

In spite of the name, morning sickness doesn't only occur in the morning. Dramatic increases in hormonal levels during pregnancy most likely precipitate these bouts of nausea and vomiting. Fortunately, morning sickness typically resolves by the end of the first trimester. Elizabeth Burch, N.D., author of Natural Healing for the Pregnant Woman (Perigee), advises women to keep a variety of foods on hand to deal with morning sickness.

"There is nothing that works for everyone," she says, "so try sipping on carbonated beverages; drinking herbal beverages that settle the stomach, such as raspberry, chamomile or peppermint tea; chewing on crystallized ginger; or taking up to one gram a day of dried ginger in capsule form." Eating small, frequent meals, and taking prenatal vitamins with a meal also helps.

Having suffered severe morning sickness with her third child, Burch now offers simple nutrition advice to her patients: "Eat anything — whatever sounds good," she says, "and during periods or days when you feel better, focus on eating well again." Severe nausea and vomiting can lead to dehydration and electrolyte imbalances, so seek help from your health care provider if you simply can't keep anything down. Odors often trigger a relapse of morning sickness. Identifying and avoiding offensive sources, such as cooking smells or the coffee pot at work, can be helpful.

Other common problems of pregnancy, such as indigestion, heartburn and constipation, don't have to take the glow out of being pregnant, either. If constipation is a problem, be sure you're drinking at least 10 to 12 cups of fluid a day. Count all fluids, including water, milk, juice, herbal teas and soup. Eat plenty of high-fiber foods, such as whole grain breads and cereals, and fresh fruits and vegetables, too. To avoid indigestion, eat slowly, cut back on fatty foods and don't consume acidic foods, such as orange juice, on an empty stomach. Heartburn is a frequent complaint during the last three months of pregnancy when the baby grows rapidly and pushes on the surrounding digestive organs. Go easy on spicy, fatty foods, and eat smaller, more frequent meals. Save beverages to sip after a meal rather than at mealtimes.

Remember, this is the time to take charge of your pregnancy and make healthy changes in your lifestyle. Even with a supporting cast of characters that can make your life more difficult, once that beautiful baby is in your arms, all will be forgotten.

Suzanne Girard Eberle is a freelance health writer living in Portland, Ore.